January 1996 Bulletin

'...and now let's go into the audience

Future CME courses will be interactive, stimulating

Don't be surprised if one day you find that your Academy continuing medical education course is structured like a TV quiz show or that the moderator is "working" the audience with a cordless microphone like Phil Donahue.

Maybe you'll be participating in a town hall meeting or intensively debating the merits of a treatment.

"Stump the panel," pro-con teams, and case presentations also were among the ideas for new CME teaching techniques explored by the members of the Committee on Educational Programming and comprehensive course chairmen last November.

They want to replace the traditional course that relies entirely on didactic 15- to 20-minute presentations by a parade of lecturers showing slides in a darkened room with an interactive educational experience that stimulates discussion and audience participation.

Enhance retention

It's more than an attempt to be less boring or to be entertaining. The bottom line is to enhance the retention and application of information to provide quality care of patients.

In a provocative 1994 article in The Journal of Continuing Education in the Health Professions, Donald E. Moore Jr., PhD, described the traditional lecture-dominated format as "episodic and not reinforcing; little evidence of impact on physician practice or patient outcomes; minimal collaboration between learners and CME providers; lack of timely response to physician-learner needs; emphasis on credit; and focus on course production driven by an enrollment economy."

It's doubtful that didactic presentations will disappear, but the committee is encouraging course chairmen to use other teaching techniques that are stimulating and participatory. The committee wants registrants to not only be active participants in the learning experience, but also to have input into the material presented so that it meets their needs.

The effort to restructure the Academy's CME programs began in March 1993 at a Committee on Educational Programming workshop to assess the cost and effectiveness of the Academy's CME courses. While the overall program was successful, the committee believed there could be improvements in course quality and production costs.

Demands on planners

Health care reform, the increasing use of continuous quality improvement and outcomes management, and the explosion of information and technology was putting new demands on CME planners.

Joseph S. Barr, MD, chairman of the Committee on Educational Planning, said members recognized that time-limited certificates would start rolling over in 1996 and 600 orthopaedists would have to recertify every year. Budgets were getting tighter, providing less time and money for travel. "There was a need for greater cost-effectiveness in CME," Dr. Barr said.

The committee also saw that there were many competing CME opportunities offered by specialty societies and industry-sponsored courses and that the opening of the Orthopaedic Learning Center in 1994 would mean an end to surgical skills courses in hotel settings.

The Academy developed a new strategy to increase the number of comprehensive courses while reducing the overall number of one- and two-day programs. Instead of the 30 to 35 courses in the past, many of which were one- and two-day courses, this year there will be 10 comprehensive courses, 10 surgical skills courses, and four review courses.

The comprehensive course concept enhanced course quality in a number of ways. It limited variations in faculty, location, chairmen, and subject matter. Condensing multiple course material into fewer courses also improved efficiency for staff, faculty, and participants.

Guidelines established the content as 75 percent review, and 25 percent flexible to accommodate new methods and technologies. The guidelines emphasize the need to develop innovative educational techniques and interactive education. Course chairmen were encouraged to meet during a course to evaluate the progress and possible modifications and, as a program ends, to plan for modification of the following year's course.

The November committee meeting brought together nine members of the Committee on Educational Programming and 11 course chairmen. In addition to innovative teaching techniques, they discussed ways to broaden the scope of comprehensive courses.

Peter C. Amadio, MD, and Edwin T. Wyman Jr., MD, respectively, discussed how to include outcome and occupational health issues in the comprehensive courses. George S. Bassett, MD, and Thomas S. Renshaw, MD, discussed including information about pediatrics; and Joseph D. Zuckerman, MD, urged the use of videos made in the Orthopaedic Learning Center or those in the Academy inventory.

The group later formed small group sessions where they discussed the planning and progress of the comprehensive courses for 1996.

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